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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. POM 248928
Regular
May 12, 2006

MARK MICELI vs. JACUZZI, INC., REMEDYTEMP, INC., AMERICAN HOME ASSURANCE CO., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL INDEMNITY CO., In Liquidation

The Court of Appeal reversed the Appeals Board's prior decision, finding that the special employer's insurance (American Home Assurance Co.) was not "other insurance" available to the applicant. This ruling invalidated the previous dismissal of CIGA and dictated that the case be returned for further proceedings. The Appeals Board, following this remittitur, rescinded the prior consolidation and stay order, denying RemedyTemp's request for dismissal and CIGA/RemedyTemp's request for a new consolidation. Assurance's petition for appeal costs was also dismissed as it was filed with the wrong entity.

CIGARemedyTempJacuzziAmerican Home Assurance Co.Reliance National Indemnity Co.special employergeneral employerother insuranceInsurance Code section 1063.1(c)(9)remittitur
References
Case No. VEN 0115536
Regular
Aug 04, 2008

ROBERT FROELICH vs. CONTRACTORS LABOR POOL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCATION, RELIANCE NATIONAL INSURANCE CO., GM NORTHROP CORP., NATIONAL FIRE INSURANCE COMPANY OF HARTFORD

This case concerns a dispute over workers' compensation liability following an industrial injury sustained by an employee who was a general employee of Contractors Labor Pool (insured by insolvent Reliance) and a special employee of GM Northrup Corp. The Workers' Compensation Appeals Board granted reconsideration to reverse a prior finding, determining that National Fire Insurance Company's policy for GM Northrup Corp. constituted "other insurance." Consequently, National Fire Insurance Company is now liable for the applicant's benefits, and the California Insurance Guarantee Association is not liable as the claim is not a "covered claim."

CIGAReliance National InsuranceNational Fire Insurance Companycovered claimsother insurancegeneral employerspecial employerjoint and several liabilitypolicy constructionInsurance Code section 1063.1
References
Case No. ADJ1200873 (OAK 0337904) ADJ479879 (OAK 0337905)
Regular
Apr 06, 2009

CARMEN CHACON vs. NATIONAL UPHOLSTERING CO., NATIONAL LIABILITY & FIRE INS. CO.

The Workers' Compensation Appeals Board (WCAB) rescinded an approved Compromise and Release (C&R) agreement due to potential mutual mistake of fact regarding duplicate payments of Temporary Disability Indemnity (TDI) and Unemployment Insurance (UI). Both the defendant and the Employment Development Department (EDD) sought reconsideration, arguing the original order did not adequately protect their interests regarding these duplicate payments. The WCAB found that EDD's due process rights were violated by a lack of proper notice and service regarding the C&R. The matter was returned to the trial level for a new decision to determine if a mutual mistake occurred and to consider EDD's lien.

Workers' Compensation Appeals BoardCarmen ChaconNational Upholstering Co.National Liability & Fire Ins. Co.Employment Development Department (EDD)Compromise and Release (C&R)Order Approving Compromise and Release (OACR)Mutual Mistake of FactDuplicate PaymentsTemporary Disability Indemnity (TDI)
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. POM 248928
Significant
May 12, 2006

Mark Miceli, Plaintiff vs Jacuzzi, Inc.; RemedyTemp, Inc.; American Home Assurance Co.; California Insurance Guarantee Association for Reliance National Indemnity Co., In Liquidation

The Appeals Board, following a remittitur, determined that a special employer's insurance policy is not 'other insurance' under Insurance Code section 1063.1(c)(9). As a result, the California Insurance Guarantee Association (CIGA) was denied dismissal from the case involving the general employer's insolvent insurer.

RemittiturEn BancDecertified OpinionInsurance Code section 1063.1(c)(9)Other InsuranceCalifornia Insurance Guarantee Association (CIGA)Reliance National Indemnity Co.LiquidationRemedyTempInc.
References
Case No. ADJ1976073
Regular
Nov 09, 2009

JAMES GROVER vs. MVP HYDRATEC, INC., CLARENDON NATIONAL INSURANCE COMPANY, administered by F. A. RICHARDS and ASSOCIATES, REMEDYTEMP, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by INTERCARE INSURANCE SERVICES for RELIANCE NATIONAL INDEMNITY CO., in liquidation

The WCJ erred in making CIGA liable; Clarendon is "other insurance" available to applicant within the meaning of Insurance Code section 1063.1(c)(9) and liable for workers' compensation benefits.

California Insurance Guarantee AssociationCIGAgeneral employerspecial employerother insuranceReliance National Indemnity CompanyClarendon National Insurance CompanyInsurance Code section 1063.1(c)(9)covered claimsinsolvency
References
Case No. ADJ2045406 (ANA 0372895)
Regular
Dec 01, 2008

CARLOTA BAHNEY vs. PROULX MANUFACTURING CO., TRAVELERS PROPERTY CASUALTY CORPORATION, APPLIED WORKFORCE SOLUTIONS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL, INTERCARE INS.

This case involves a dispute between Travelers Property Casualty Corporation and the California Insurance Guarantee Association (CIGA) regarding reimbursement for workers' compensation benefits paid to an applicant. CIGA stepped in to cover benefits after the original insurer, Reliance National, became insolvent. Both parties sought reconsideration of an arbitrator's decision that favored CIGA, but due to procedural issues, including a missing summary of evidence and the arbitrator's unavailability, the Appeals Board rescinded the decision. The case is now returned to the trial level for a new arbitrator to hear the evidence and make an initial determination.

CIGATravelersReliance Nationalliquidationcontributiongeneral employerspecial employerarbitrationcompromise and releaseindustrial injury
References
Case No. ADJ7601670 ADJ9457797 ADJ9576710
Regular
Jun 28, 2016

MARGARITA GUTIERREZ vs. DYNAMIC DETAILS, INC, ACE FIRE UNDERWRITERS INS. CO., ESIS, THE HARTFORD INS. CO., EVEREST NATIONAL INS. CO., SEDGWICH CMS

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration. The WCJ had previously issued an order vacating the original findings and setting a status conference. This order vacating the decision was issued within the 15-day period allowed for a WCJ to amend, modify, or rescind an award after a petition for reconsideration is filed. Therefore, the applicant's petition for reconsideration became moot and was properly dismissed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderWorkers' Compensation Administrative Law JudgeOrder VacatingWCAB Rule 10859Moot PetitionOrder Denying Petition for RemovalChairwoman CaplaneCommissioner Sweeney
References
Case No. ANA 352921
Regular
Oct 02, 2007

STEPHEN GRIFFIS vs. ORANGE COUNTY FIRE AUTHORITY, CIGA on behalf of RELIANCE NATIONAL INSURANCE COMPANY, in liquidation, AIG CLAIMS SERVICES

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision regarding an applicant's cumulative trauma injury to May 12, 1997. The WCAB found that AIG, as "other insurance," is liable for all benefits awarded after Reliance National Insurance Company (Reliance) became insolvent on October 3, 2001. Consequently, the California Insurance Guarantee Association (CIGA) is entitled to reimbursement from AIG for all benefits CIGA paid after Reliance's liquidation.

CIGAReliance National InsuranceAIG Claims Servicescumulative traumabilateral hearing lossstipulated awardliquidationreimbursementother insurancecovered claim
References
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